Are you doing minimally invasive surgery or traditional large incision surgery?
Standard and adequate systematic rehabilitation training is an indispensable and important component in the treatment of gluteal muscle contracture (splayed legs, frog legs) and the prevention of new adhesions and contractures. It is also indispensable to enhance the patient's confidence in rehabilitation. link. When all movements are as comfortable as normal people, you can stop targeted exercises.
1. Rehabilitation to prevent or improve contracture
Purpose: to maintain the length after extension, improve skin contracture and increase ligament flexibility
1. Combined knee flexion There are two types of hip flexion and knee flexion (or squat) exercise: active exercise and passive exercise; passive hip flexion and knee flexion is suitable for conservative treatment patients under 6 years old who cannot understand the purpose and method of exercise and cannot actively cooperate and in the early postoperative period (1 Within weeks, 12 hours after minimally invasive surgery) patients who need exercises to assist drainage but cannot exercise well due to pain. Specific method: After fixing the knees together, the operator lifts the patient's feet so that the soles of the feet are in contact with the operator's chest, holds the patient's calf ankles with both hands, applies force slowly with both hands and chest, and instructs the patient to take a deep breath to fully flex the hips and knees. There are 3-4 patients in each group, conservative treatment patients need 6-8 groups every day, and postoperative patients need 3-4 groups every day. Once the pain from passive exercise is relieved, start active exercise. Fix your knees together and grab a solid support with both hands to perform squat training. The required number of times is the same as passive.
2. Cross-overlapping hip and knee flexion exercises for both lower limbs (sitting with legs crossed), the active and passive operation requirements are the same as those for knee-joint exercises, but the start time is 1-2 days later than the knee-joint exercises, and every First practice joining the knees and then practicing crossing the knees to reduce pain and increase adaptability.
3. Cross your legs throughout the whole process (also known as the devil's move): hold (or pull) your hands firmly, then cross your legs and squat down to stand up with one leg, 5 times for each leg, alternating the two legs once. Group.
4. Hold the knee joint and touch the shoulder method: After sitting firmly, hold the knee joint of the right calf with both hands to approach the left shoulder, as close as possible until contact; then hold the knee joint of the left calf with both hands to approach the right shoulder, and repeat the training alternately , the knee joint is always adducted and internally rotated during the knee hugging process.
2. Prevent residual hemorrhage
Since the working chambers for non-minimally invasive surgery in the greater trochanter area are both before and after the incision, the patient is required to lie supine and lie down alternately for 2 hours. Once, especially in the early stages of exercise, positions should be exchanged once after each group, with an interval of about 15 minutes. During minimally invasive surgery, since the working chamber is located in front of the incision, there is no need to lie prone. You only need to perform regular exercises to increase the pressure in the working chamber and squeeze out the accumulated blood.
3. Rehabilitation of the adductor muscles
Purpose: to increase the strength of the adductors and abductors
The patient bends slightly and grasps the fixture with both hands. When the standing lower limbs are moved back later, you need to practice swinging the lower limbs forcefully from side to side. Especially when adducting and swinging, you need to swing as high as possible. Remember that the trunk must be neutral and stable during the swing process and cannot rotate. The swinging lower limbs must be in an internal rotation position. Swing one side 10 times and then switch to the other lower limb to swing in the same way. The exercise should start 1 week after the operation for those with sutures, and 2 days after the operation for those without sutures. 3-4 groups per day.
4. Rehabilitation of gait and posture
Purpose: to change the original "eight-shaped" and "frog-shaped legs" gait
Look with head held high and chest raised With the landmark two meters high in front of you, walk forward in one step (i.e., model step), swing your upper limbs in coordination with the steps, and exercise no less than 3 times a day starting from the first day after surgery, and each time is at least 200 meters. , and it is also required that you must use this pace whenever you get out of bed and walk. Those with scoliosis and hip tilt before surgery must perform lateral flexion exercises to the convex side and hanging and traction of both upper limbs every day. Starting from the 3rd day after surgery, 3 groups of 10-20 lateral flexions and 5 suspensions are performed every day. -10 minutes, do deep breathing exercises while hanging.
5. Rehabilitation of internal rotation and forward flexor muscles
Purpose: to increase the strength of the adductors and abductors
Stand vertically with the arms drooping and flexing the elbows Stretch your forearms and hands flat forward, and lift your thighs with internal rotation of your lower limbs. The knees are required to flex naturally when lifting the thighs. When lifting the thighs, you should try to contact the palm of the same side as much as possible. If there are sutures, start from the 7th to 10th day after the operation. No sutures. Starting from the third day after surgery, patients can do 3 groups a day, and practice each group until the muscles are slightly sore.
6. Rehabilitation of gluteus maximus
Purpose: to make the buttocks plump to change flat and concave buttocks
Grasp the fixture with both hands and train the sides of the lower limbs Deviate from the fixture, swing the lower limbs back and forth, and lift as high as possible each time when extending backwards; exercise should start from 7-10 days after surgery for those with sutures, and from the 3rd day after surgery for those without sutures, no less than 10 days a day 3 groups, practice each group until the muscles are slightly sore, with an interval of at least 2 hours to allow them to recover.
7. Rehabilitation of the low back muscles
Purpose: To make the low back muscles strong and powerful, correct hunchback and buttocks
Lie on the bed (prone position) with your head and All limbs slowly leave the bed upwards, and the higher the limbs are straight out of the bed, the better. Only the belly (abdomen) touches the bed, and then slowly return to the bed. Each time you stretch backwards, lift as high as possible; the exercises start from the postoperative period. Starting from the first day, practice no less than 3 groups every day. Practice each group until the muscles are slightly sore, with an interval of at least 2 hours to allow them to recover. Continuing for at least 3 months, if maintained for life, it is better to protect the stability of the spine and prevent and treat low back pain.
8. Rehabilitation of pelvic tilt
Purpose: to correct the false unequal length of the lower limbs
Action 1: Lifting method: place the center of gravity of the body on standing straight On the short leg, straighten the long leg vertically and hold the foot off the ground for 2 minutes; repeat 20 times each time.
Action 2: Back-drawing method: Squat down slowly to the bottom with your knees together and always keeping them level, and then stand up slowly while keeping your knees together and level.
Action 3: Hug the knees and touch the shoulders: sit firmly and hug with both hands